title: Are informal carers and community care workers effective in managing malnutrition in the older adult community? A systematic review of current evidence.
abstract: BACKGROUND
  Enhancing the effectiveness of the community and aged care workforce to prevent malnutrition and functional decline is important in reducing hospital and aged care facility demand.
  
  
  OBJECTIVE
  To investigate the impact of nutrition-related interventions delivered to or by informal carers and non-clinical community care workers on malnutrition-related health outcomes of community-dwelling older adults (≥65 years).
  
  
  METHODS
  Intervention studies were searched for using six electronic databases for English-language publications from January 1980 to 30 May 2012.
  
  
  RESULTS
  Nine studies were eligible for inclusion. The strength and quality of the evidence was moderate (six studies with level II intervention evidence, five with positive quality). Types of interventions used were highly varied. The majority of interventions were delivered to informal carers (6 studies), with three of these studies also involving older adult care recipients. Five interventions were targeted at identifying, preventing and/or treating malnutrition specifically (two positive quality, three neutral quality, n=2368). As a result of these interventions, nutritional status improved or stabilized (two positive quality, two neutral quality, n=2333). No study reported an improvement in functional status but two successfully prevented further decline in their participants (two neutral quality, n=1097).
  
  
  CONCLUSIONS
  Interventions targeted at identifying, preventing and/or treating malnutrition were able to improve or prevent decline in nutritional and functional status, without increasing informal carer burden. The findings of this review support the involvement of non-clinical community care workers and informal carers as part of the nutritional care team for community-dwelling older adults.
authors.affiliation: Skye Marshall, School of Human Movement Studies, Room 407B, Building 26, the University of Queensland, Brisbane, Queensland, 4072, Australia. Phone: 61+ 07336 56982, Fax: 61+ 07 3365 6877, skye.marshall@uq.net.au.
authors.forename: S
authors.initials: S
authors.lastname: Marshall
authors.forename: J
authors.initials: J
authors.lastname: Bauer
authors.forename: S
authors.initials: S
authors.lastname: Capra
authors.forename: E
authors.initials: E
authors.lastname: Isenring
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D017028:Caregivers; D003695:Delivery of Health Care; D006801:Humans; D044342:Malnutrition / Q000517:prevention & control*; D009752:Nutritional Status; D005791:Patient Care; D012111:Residence Characteristics